Building your drink refusal skills

Plan ahead to stay in control

Even if you are committed to changing your drinking, "social pressure" to drink from friends or others can make it hard to cut back or quit. This short module offers a recognize-avoid-cope approach commonly used in cognitive-behavioral therapy, which helps people to change unhelpful thinking patterns and reactions. It also provides links to worksheets to help you get started with your own plan to resist pressure to drink.

Recognize two types of pressure

The first step is to become aware of the two different types of social pressure to drink alcohol—direct and indirect.

Direct social pressure is when someone offers you a drink or an opportunity to drink.

Indirect social pressure is when you feel tempted to drink just by being around others who are drinking—even if no one offers you a drink.

Take a moment to think about situations where you feel direct or indirect pressure to drink or to drink too much. You can use the form below to write them down. Then, for each situation, choose some resistance strategies from below,or come up with your own. When you're done, you can print the form or email it to yourself.

Avoid pressure when possible

For some situations, your best strategy may be avoiding them altogether. If you feel guilty about avoiding an event or turning down an invitation, remind yourself that you are not necessarily talking about "forever." When you have confidence in your resistance skills, you may decide to ease gradually into situations you now choose to avoid. In the meantime, you can stay connected with friends by suggesting alternate activities that don't involve drinking.

Cope with situations you can't avoid

Know your "no"

When you know alcohol will be served, it's important to have some resistance strategies lined up in advance. If you expect to be offered a drink, you'll need to be ready to deliver a convincing "no thanks." Your goal is to be clear and firm, yet friendly and respectful. Avoid long explanations and vague excuses, as they tend to prolong the discussion and provide more of an opportunity to give in. Here are some other points to keep in mind:

Don't hesitate, as that will give you the chance to think of reasons to go along

Look directly at the person and make eye contact

Keep your response short, clear, and simple

The person offering you a drink may not know you are trying to cut down or stop, and his or her level of insistence may vary. It's a good idea to plan a series of responses in case the person persists, from a simple refusal to a more assertive reply. Consider a sequence like this:

No, thank you.

No, thanks, I don't want to.

You know, I'm (cutting back/not drinking) now (to get healthier/to take care of myself/because my doctor said to). I'd really appreciate it if you'd help me out.

You can also try the "broken record" strategy. Each time the person makes a statement, you can simply repeat the same short, clear response. You might want to acknowledge some part of the person's points ("I hear you...") and then go back to your broken-record reply ("...but no thanks"). And if words fail, you can walk away.

Script and practice your "no"

Many people are surprised at how hard it can be to say no the first few times. You can build confidence by scripting and practicing your lines. First imagine the situation and the person who's offering the drink. Then write both what the person will say and how you'll respond, whether it's a broken record strategy (mentioned above) or your own unique approach. Rehearse it aloud to get comfortable with your phrasing and delivery. Also, consider asking a supportive person to role-play with you, someone who would offer realistic pressure to drink and honest feedback about your responses. Whether you practice through made-up or real-world experiences, you'll learn as you go. Keep at it, and your skills will grow over time.

Try other strategies

In addition to being prepared with your "no thanks," consider these strategies:

Have non-alcoholic drinks always in hand if you're quitting, or as "drink spacers" between drinks if you're cutting back

Keep track of every drink if you're cutting back so you stay within your limits

Ask for support from others to cope with temptation

Plan an escape if the temptation gets too great

Ask others to refrain from pressuring you or drinking in your presence (this can be hard)

If you have successfully refused drink offers before, then recall what worked and build on it.

Remember, it's your choice

How you think about any decision to change can affect your success. Many people who decide to cut back or quit drinking think, "I am not allowed to drink," as if an external authority were imposing rules on them. Thoughts like this can breed resentment and make it easier to give in. It's important to challenge this kind of thinking by telling yourself that you are in charge, that you know how you want your life to be, and that you have decided to make a change.

Similarly, you may worry about how others will react or view you if you make a change. Again, challenge these thoughts by remembering that it's your life and your choice, and that your decision should be respected.

Plan to resist pressure to drink

The links below will take you to forms to plan how you'll handle high-risk situations and offers to drink:

This module is adapted from the Combined Behavioral Intervention Manual: A Clinical Research Guide for Therapists Treating People with Alcohol Abuse and Dependence. It can be used with counseling or therapy and is not meant as a substitute for professional help. If you choose to try it on your own and at any point feel you need more help, then seek support (see Help Links). The full 330-page manual (NIH Publication 04-5288) can be ordered for $10 using this form (PDF 198KB).

How many "drinks" are in a bottle of wine?

A typical 25-ounce (750 ml) bottle of table wine holds about 5 "standard" drinks, each containing about 5 ounces. This serving size of wine contains about the same amount of alcohol as a 12-ounce regular beer or 1.5 ounces of 80-proof spirits.

Get to know what 5 ounces looks like by measuring it out at home. That way you can estimate how many standard drinks you're being served in a restaurant or bar that uses large glasses and generous serving sizes.

Mixing alcohol with certain medications can cause nausea, headaches, drowsiness, fainting, a loss of coordination, internal bleeding, heart problems, and difficulties in breathing. Alcohol can also make a medication less effective. For more information, see Harmful Interactions: Mixing Alcohol with Medicines.

Each year, an estimated 5,000 people under age 21 die from alcohol-related injuries.

The younger people are when they start to drink, the more likely they are to develop alcohol use disorder at some point in their lives.

Underage drinking is illegal—an arrest can lead to losing a job, a driver's license, or a college scholarship.

Even moderate amounts of alcohol can significantly impair driving performance and your ability to operate other machinery, whether or not you feel the effects of alcohol.

Heavy drinking during pregnancy can cause brain damage and other serious problems in the baby. Because it is not yet known whether any amount of alcohol is safe for a developing baby, women who are pregnant or may become pregnant should not drink.

Highest risk

About 50% of people who drink in this group have alcohol use disorder.

Increased risk

This "increased risk" category contains three different drinking pattern groups. Overall, nearly 20% of people who drink in this category have alcohol use disorder.

Low-risk drinking

Only about 2% of drinkers in this group has alcohol use disorder.

A U.S. standard drink contains about 0.6 fluid ounces or 14 grams of pure alcohol (also known as an alcoholic drink-equivalent). That's the amount in 12 ounces of regular beer, 5 ounces of table wine, or 1.5 ounces of 80-proof distilled spirits.

Distilled spirits include vodka, whiskey, gin, rum, and tequila.

Light to moderate drinking

Men: Up to 2 drinks per day

Women: Up to 1 drink per day

Heavy or at-risk drinking

Men: More than 4 drinks on any day or more than 14 drinks per week

Women: More than 3 drinks on any day or more than 7 drinks per week

Low-risk drinking

Men: No more than 4 drinks on any day and no more than 14 per week

Women: No more than 3 drinks on any day and no more than 7 per week

People with a parent, grandparent, or other close relative with alcoholism have a higher risk for becoming dependent on alcohol. For many, it may be difficult to maintain low-risk drinking habits.

Pace yourself: It's best to have no more than one standard drink per hour, with nonalcoholic "drink spacers" between alcohol beverages. On any day, stay within low-risk levels of no more than 4 drinks for men or 3 for women. Note that it takes about 2 hours for the adult body to completely break down a single drink. Do not drive after drinking.